Exercise-induced ventricular arrhythmias in patients with coronary artery disease. Their relation to angiographic findings

Ventricular extrasystoles occurring before, during or after graded exercise testing were related to extent of coronary artery disease and to ventricular motion disorders in 81 symptomatic patients undergoing selective coronary and left ventricular angiography; the results were compared with data in 89 similar age-matched patients without arrhythmias. Compared with arrhythmia-free patients, 67 patients with exercise-induced arrhythmias had a significantly greater incidence of prior myocardial infarction, double or triple vessel disease and overall abnormal ventricular contractile patterns. Exercise induced extrasystoles occurred in only 11 percent of patients with insignificant coronary disease. Abolition of resting extrasystoles by exercise was not associated with less extensive coronary disease. Our study suggests that exercise-precipitated arrhythmias may represent a form of subclinical ischemia, signify more advanced degrees of coronary and left ventricular disease, and serve as an aid in detecting potentially high-risk patients.